EAR/RESP Flashcards
How would you explain the ear assessment
I’ll now be doing an ear ax which involves me palpating and then looking into your ear with an otoscope. I will then be doing a whisper test which screens for deafness
What order does the ear ax go in
Inspect, palpate, otoscope, whisper test
What are you inspecting for when doing the ear ax
Inspecting for any scars, lesions, swelling, discharge that you can see from the opening of the ear canal
How do you straighten the ear canal prior to putting otoscope in?
Straighten it by pulling it upwards and then backwards
What is important to tell the client PRIOR to doing the otoscope ax
Explain why you’ll be holding the otoscope upside down - prevents me damaging the ear canal if the pt were to move or sneeze, gives me more stability whilst holding it.
How far do you put the otoscope in? And how do you check the otoscope prior to entering
Only a little bit!! You dont put the whole thing in VERY IMPORTANT.
Turn the light on of the otoscope before putting it in
Normal findings of what you see in ear using otoscope
Pearly grey tympanic membrane - some cerumen, STATE you can see the cone of light at what time?
7pm left
5pm right
Whisper test explain how you would explain it to client and how to do the whole ax
I will now be doing the whisper test, this will require me to say three words, once you hear me say a word please repeat it back to me. We will test both ears. I will need you to block one ear for me.
- *If the person has hearing aids dont do this test.
- *If the person struggles with some words then come closer and repeat.
Stand 1 metre behind the pt, whisper the words slowly. Explain findings.
How would you explain the resp ax to the pt / and then how would you set up for the assessment with the pt?
What I’d like to do now is a posterior chest ax - this involves me inspecting your back and checking your spine alignment, I’ll then feel your back to check your lung expansion, I’ll then tap your back with my fingers to check where your lung fields are and then listen to your lungs with a stethoscope. Is this ok with you
Give the pt a top - give privacy - raise the bed to your height once they’re on it and WASH YOUR HANDS
What order are you doing the resp ax in
Inspection - Palpation - Percussion - Auscultation
How would you inspect
I’m inspecting the
straightness of spine - any curvature?
accessory muscles - are equal not one higher than the other
temp - warm?
skin colour - uniform, lesions or swelling?
AP
Palpation - how would you do this - what are normal findings
Put hands around the T10 level. Ask them t take a deep breath in an out twice. See if there is any difference between the 2. Normal - that is a nice even chest expansion.
Percussion - how would you do this - and what sounds are you describing?
Percuss at the top near shoulders
Then percuss on either side of the spine downwards
Find the base of the lungs by hearing resonance/dullness
Once you’ve found the base of the lung, take the percussing out from spine to see where the full base of lung is
Confirm where you think the lung is then auscultate
Auscultation - how would you o this and what sounds are yu hearing and where? How would yu prompt the client at the start of this
I’ll need you to breathe slowly through your mouth and have your mouth slightly open. When you feel the bell of the stethescope touch your back that’s just when I’d like you to take a breath. If you start feeling light headed at all just let me know.
- Warm up bell of stethescope
Auscultate two on each shoulder, either side of spine down warsd then outwards from spine at bottom lung field.
Sounds - vesicular sounds at the apex/top and base/bottom of your lungs, where the inspiration was LONGER than expiration. then bronchovesicular sounds in between your scapula where your insp is the SAME length as your expi which is expected.
